Abstract:
BACKGROUND:Myocardial deformation imaging using speckle-tracking echocardiography to assess global longitudinal strain (GLS) is today considered a more sensitive measure of left ventricular (LV) systolic function than ejection fraction. General anesthesia and positive pressure ventilation (PPV) are known to change the right ventricular (RV) and LV loading conditions. However, little is known about the effects of anesthesia and PPV on RV free wall and LV GLS. We studied the influence of general anesthesia and PPV on RV and LV longitudinal strain in patients without myocardial disease. METHODS:Twenty-one patients scheduled for non-cardiac surgery were included. The baseline examination was performed on the un-premedicated patients within 60 min of anesthesia. The second examination was performed 10-15 min after induction of anesthesia (propofol, remifentanil), intubation and start of PPV. The examinations included apical four-, two- and three-chamber projections, mitral and aortic Doppler flow velocities and tissue Doppler velocities of tricuspid and mitral annulus. LV end-systolic elastance (Ees) and aortic elastance were determined (Ea). RESULTS:General anesthesia and PPV reduced the mean arterial blood pressure (- 29%, p < 0.0019), stroke volume index (- 13%, p < 0.001) and cardiac index (- 23%, p < 0.001). RV end-diastolic area index and LV end-diastolic volume index decreased significantly, while systemic vascular resistance was not significantly affected. Ees decreased significantly with the induction of anaesthesia (- 23%, p = 0.002), while there was a trend for a decrease in Ea (p = 0.053). The ventriculo-arterial coupling, Ea/Ees, was not significantly affected by the anesthetics and PPV. The LV GLS decreased from - 19.1 ± 2.3% to - 17.3 ± 2.9% (p < 0.001) and RV free wall strain decreased from - 26.5 ± 3.9% to - 24.1 ± 4.2% (p = 0.001). One patient (5%) had at baseline a LV GLS > - 16% compared with 6 patients (28%) during general anesthesia and PPV. Three patients (14%) had a RV free wall strain > - 24% compared to 8 patients (38%) during general anesthesia and PPV. CONCLUSIONS:General anesthesia and PPV reduces systolic LV and RV function to levels considered indicating dysfunction in a substantial proportion of patients without myocardial disease.
journal_name
Cardiovasc Ultrasoundjournal_title
Cardiovascular ultrasoundauthors
Dalla K,Bech-Hanssen O,Ricksten SEdoi
10.1186/s12947-019-0165-zsubject
Has Abstractpub_date
2019-08-10 00:00:00pages
16issue
1issn
1476-7120pii
10.1186/s12947-019-0165-zjournal_volume
17pub_type
杂志文章abstract::This review article summarizes the results of histopathological studies to assess heart failure in humans. Different histopathological features underlying the clinical manifestations of heart failure are reviewed. In addition, the present role of echocardiographic techniques in assessing the failing heart is briefly s...
journal_title:Cardiovascular ultrasound
pub_type: 杂志文章,评审
doi:10.1186/1476-7120-5-5
更新日期:2007-01-30 00:00:00
abstract:BACKGROUND:Left ventricular (LV) ejection fraction (LVEF) assessed by two-dimensional echocardiography (2DE) is the most widely used parameter for clinical decision-making, but reproducibility and accuracy problems remain. We evaluated the usefulness of a novel training program based on cardiac magnetic resonance (CMR)...
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章,评审
doi:10.1186/s12947-016-0048-5
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-7-44
更新日期:2009-09-04 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1186/1476-7120-10-8
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/s12947-020-00198-y
更新日期:2020-06-12 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-8-41
更新日期:2010-09-15 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-5-14
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/s12947-015-0036-1
更新日期:2015-10-05 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 临床试验,杂志文章
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-7-4
更新日期:2009-01-29 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-11-23
更新日期:2013-06-27 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-9-38
更新日期:2011-11-24 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-9-8
更新日期:2011-02-28 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-8-35
更新日期:2010-09-01 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-4-31
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章,评审
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-11-8
更新日期:2013-03-11 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章,评审
doi:10.1186/1476-7120-3-27
更新日期:2005-09-08 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
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更新日期:2016-09-07 00:00:00
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pub_type: 杂志文章
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更新日期:2016-06-01 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/s12947-019-0157-z
更新日期:2019-04-06 00:00:00
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/s12947-015-0039-y
更新日期:2015-11-20 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章
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journal_title:Cardiovascular ultrasound
pub_type: 杂志文章
doi:10.1186/1476-7120-4-9
更新日期:2006-02-02 00:00:00